Disastrous pharma ruling

[Scooter]

You can carp all you want about what should happen, but in the real world, where the rest of us live, doctors' prescribing habits are influenced by a lot of things, including what drug reps tell them and what their patients ask them for.

[Sue U]

Let's take a real world example of highly advertised drugs -- for example, Viagra, Cialis and Levitra. There are no generics. All produce similar physiological results. Which does a doc prescribe? Why?

[Sue U]

If it was the best treatment, then he wouldn't necessarily need to prescribe Curesitall. He could prescribe a generic alternative

Are you aware that generic drugs are not actualy the same as brand-name, and that there can be wide variability in therapeutic effectiveness?

[Joe Guy]

Let's take a real world example of highly advertised drugs -- for example, Viagra, Cialis and Levitra. There are no generics. All produce similar physiological results. Which does a doc prescribe? Why?

A good doctor first tests to see what the cause is for the patient's problem. Assuming that he decides a prescription is a good treatment, he then researches the contraindications of each drug and potential interactions with other drugs and then prescribes what he thinks is best for the patient.

As an aside - I get advertisements for generic Viagra & Cialis (and many other drugs) on-line sometimes in my spam folder. I don't know whether they're real or not.

[Joe Guy]

Are you aware that generic drugs are not actualy the same as brand-name, and that there can be wide variability in therapeutic effectiveness?

I'm aware that there can be differences in effectiveness between generic and brand name drugs although I believe that wouldn't apply to the majority of them. A good doctor would know that and prescribe accordingly.

Also, "variability in therapeutic effectiveness" doesn't always mean that the brand name is the most effective.

[MajGenl.Meade]

Let's take a real world example of highly advertised drugs -- for example, Viagra, Cialis and Levitra. There are no generics. All produce similar physiological results. Which does a doc prescribe? Why?

It's not hard . . . to choose . . .



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[rubato]

Let's take a real world example of highly advertised drugs -- for example, Viagra, Cialis and Levitra. There are no generics. All produce similar physiological results. Which does a doc prescribe? Why?

There is excellent social psychology research dating back > 30 years which proves that all of the cheap 'freebies' work. Free medical books, free desk toys, free pads, pens, stethoscopes. They all have a huge effect on behavior even when the subject claim they don't. And I'm not getting to the outright bribery of free trips, speaking honoraria (where they provide the script and the presentations).

Kaiser eliminates all such contact between MDs and pharma representatives. They do allow medical device/drug makers to have Kaiser Doc give technical presentations in-house (no travel, no free meals, no speaking fees). Such as Implanon, a long-term birth control drug which is implanted in the arm.

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rubato